Internal Medicine

0521779407-14 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:16

Miliaria 985

Different Forms of Miliaria

■Crystallina:

➣small, clear superficial vesicles without inflammation

➣appears often in bedridden patients or patients wearing tightly

bound clothes

➣asymptomatic and self-limited

■Rubra:

➣discrete, extremely pruritic erythematous papulovesicles

➣sensation of prickling, burning or tingling

➣predilection for antecubital fossa, popliteal fossa, trunk, intert-

riginous areas, and waistline

■Pustulosa:

➣always preceded by a dermatitis that produces injury, destruction

or blocking of the sweat duct

➣pustules are distinct and independent of hair follicles

➣intertriginous areas, flexural surface, scrotum, and back

■Profunda:

➣nonpruritic, flesh-colored, deep-seated white papules

➣asymptomatic

➣last about 1 hour after overheating has ended

➣concentrated on trunk and extremities

➣all sweat glands are nonfunctional except on face, axillae, hands

and feet

➣observed usually in tropics and usually follows bout of miliaria

rubra

tests

n/a

differential diagnosis

■Transient Acantholytic Dermatosis

■Pustular psoriasis

■Acute generalized exanthematous pustulosis

■Candidiasis

■Folliculitis

management

■Place patient in cool environment.

■Circulating fans

specific therapy

■Anhydrous lanolin helps to resolve occlusion of pores.